| Tungseth Psychotherapy Clinic Llc | |
|
6233 Durand Ave Suite F Racine WI 53406-4961 | |
| (262) 554-8165 | |
| (262) 554-8152 |
| Full Name | Tungseth Psychotherapy Clinic Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6233 Durand Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Margaret J Tungseth (DIRECTOR) |
| Authorized Official Contact | 2625548165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tungseth Psychotherapy Clinic Llc 6233 Durand Ave Suite F Racine WI 53406-4961 Ph: (262) 554-8165 | Tungseth Psychotherapy Clinic Llc 6233 Durand Ave Suite F Racine WI 53406-4961 Ph: (262) 554-8165 |
| NPI Number | 1609927011 |
|---|---|
| Provider Enumeration Date | 01/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609927011 | NPI | - | NPPES |
| 42236800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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